MEDICARE: ARDENT NURSING AND HOMECARE OF TEXAS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1689290835
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARDENT NURSING AND HOMECARE OF TEXAS PLLC

Provider Business Mailing Address
First Line	:	5804 BABCOCK RD # 369
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-2134
Country	:	US
Telephone Number	:	210-325-5240
Fax Number	:

Provider Business Practice Location Address
First Line	:	4040 BROADWAY ST STE 240
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-6300
Country	:	US
Telephone Number	:	210-721-5048
Fax Number	:	210-721-5047

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	RENA LEWIS
Credential	:	REGISTERED NURSE
Telephone Number	:	210-601-3443

Provider Enumeration Date	:	06/24/2020
Last Update Date	:	06/24/2020

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